Provider Demographics
NPI:1699220533
Name:SCHMEROLD, AMY LEA (RN, MSN, AGPCNP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LEA
Last Name:SCHMEROLD
Suffix:
Gender:F
Credentials:RN, MSN, AGPCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 S WOODS MILL RD STE 620S
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3619
Mailing Address - Country:US
Mailing Address - Phone:636-685-7788
Mailing Address - Fax:314-205-6377
Practice Address - Street 1:224 S WOODS MILL RD STE 620S
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3619
Practice Address - Country:US
Practice Address - Phone:636-685-7788
Practice Address - Fax:314-205-6377
Is Sole Proprietor?:No
Enumeration Date:2016-08-21
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016005844363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOQ00075473OtherRR MEDICARFE